INNOVATIVE TYPES OF RADIATION THERAPY FOR CANCER – Dr med Peter Stoll

---

Dr. med. Peter Stoll is a specialist in diagnostic radiology and modern radiation oncology. The doctor began his clinical practice in 1997, after studying medicine in Heidelberg, Camden/New Jersey (USA), and Cape Town (South Africa). Dr. Stoll specializes in radiation therapy and nuclear medicine in general, and oncology treatment in particular. According to the ranking of the famous medical magazine FOCUS, he is recognized as one of the best radiation therapists in Munich.

Now Dr. Stoll sees patients at the Radiation Oncology Clinic Pasing Munich. He is the Head of the Department of Radiation Oncology. His medical team uses innovative equipment for high-precision irradiation of prostate, breast, colon, and brain tumors, as well as for the treatment of cancer in other localizations. A particular advantage for patients is the doctor's qualifications in the field of comprehensive cancer treatment, as Dr. Stoll does not only use radiation therapy but also talks about the optimal treatment regimens in each specific case.

In the interview, we are going to talk with Dr. Stoll about the reasons for the high effectiveness of radiation therapy in Germany, modern types of radiation therapy for different types of cancer, and innovative equipment for carrying out radiation therapy.

Hello, Dr. Stoll! Thank you for taking the time to give us an interview today. Please tell us about yourself!

First of all, I would like to thank you. I am honored that you represent us on Bookinghealth.com.

My name is Peter Stoll. I specialize in radiation oncology, radiology, and internal medicine. I am the director and owner of the Radiation Oncology Clinic Pasing in Munich. We treat many patients with cancer and with benign pathologies, such as rheumatism and other conditions. I have been treating cancer for many years.

I graduated from the university and then worked for many years in the field of diagnostic imaging at the University Hospital Rechts der Isar. It is this experience that helps me a lot when I need to interpret images received from abroad, since today diagnostic results can be sent to a doctor via the Internet.

Training in the field of internal medicine allows me to provide medical care considering the peculiarities of the human body.

Dr. Stoll, could you please tell us how many foreign patients you admit per year?

We admit a huge number of foreign patients. More precisely, about 20-25% of all our patients come from abroad. The main reason is that we have state-of-the-art equipment, and we will talk more about this today, as well as an excellent team of experienced doctors, medical technical assistants, and physicists in our clinic.

The popularity of our clinic is certainly facilitated by its location in Munich, which is a world-famous cosmopolitan city. Patients like that they will receive high-quality treatment. And what is more, they will be able to walk around the city and get acquainted with the national traditions of Germany.

From which countries do patients come to you?

We treat many patients from the post-Soviet states, primarily from Ukraine and Russia. Many patients also come from Kazakhstan, Georgia, and Uzbekistan. Of course, we also treat patients from Arab countries. We admit patients from Spanish speaking countries.

Perhaps this is due to the fact that the clinic has an international team of doctors, including employees who are fluent in Russian because they are of Russian or Ukrainian origin. The doctors also speak Spanish and, of course, English. An international medical team is an advantage for our patients.

Dr. Stoll, with what diseases do patients most often come to you?

Most often, we admit patients with prostate cancer and breast cancer. These two types of cancer are the most common ones. Nonetheless, we also often treat lung cancer, brain tumors, lymphomas, blood cancer, and many other diseases for which patients may receive radiation therapy.

Dr. Stoll, when can cancer patients receive radiation therapy?

Modern cancer treatment is no longer based on the concept that a patient simply receives a certain type of therapy. The doctors need to carefully analyze the clinical case and the peculiarities of the patient, for example, the age, gender, and so on.

The patient's current health condition must be taken into account. Only after that does the doctor choose the necessary types of therapy from the many available in modern medicine. If the specialist manages to choose the type of therapy that, in combination with other methods, will give the best result, then the patient has the highest chances of recovery.

Dr. Stoll, how effective is radiation therapy for throat cancer?

If you don't mind, I would like to tell a story. I am sure you will be interested in it. 

A few years ago, we had a patient with throat cancer. The stage of cancer did not allow for a local tumor resection, but he still had chances of recovery. He was advised to completely remove the larynx. Naturally, such a verdict is a shock for any person, and for an opera singer, this is a real tragedy.

Desperate, he came to us for help to find out if there were any alternative treatment options. I said I would think about what we could do. After reviewing the clinical data, we decided to proceed with radiation therapy. Basically, the chances of a successful outcome of radiation therapy are the same at any stage. Eventually, we carried out radiation therapy. This special mask was also used during the irradiation (see video).

Toward the end of the course of radiation therapy, patients will have to go through a difficult period because of swallowing disorders and other issues. He also had to go through these difficulties, but, as a rule, such disorders disappear relatively quickly. After some time, the patient came to us for a follow-up exam and began to sing again.

This is just one example, but such stories always make me very happy. Thanks to them, I understand why I love my job so much.

Is radiotherapy a stand-alone treatment, or should it be combined with other therapies?

Both options are possible. Radiation therapy is very often used in combination with other therapies, for example, in combination with chemotherapy for certain types of colon cancer or after surgery for breast cancer. However, radiation therapy can also be used as monotherapy for other diseases, for example, prostate cancer. It is worth noting that radiation therapy is very effective for many types of prostate cancer.

With regard to cancer control methods, such as surgery, in certain cases, radiation therapy is a good alternative to surgery since it has fewer severe side effects.

Dr. Stoll, when can radiation therapy be the only treatment option?

A good example is prostate cancer.

Also, these are cases where patients do not want to undergo surgery or when it is contraindicated for them, such as in brain tumors. In such cases, irradiation is performed.

There are different types of cancer and different stages of oncopathology in which radiation therapy is used, since this is the treatment that suits the patient the most. In this regard, colon cancer, especially distal colon tumors, is a striking example.

Previously, patients with these types of cancer underwent surgery, after which fecal incontinence developed. Today, doctors use radiation therapy in combination with low-dose chemotherapy. The results of such treatment are comparable to those of a surgical technique, but the function of the anal sphincter is preserved. That is why now the treatment is carried out only using such an approach.

Are there any differences in irradiation methods?

I performed radiation therapy for the first time in 1997. At that time, irradiation was made as it was customary then: from four sides. Most hospitals did not yet have computer technology. Due to the progress in computer technology, methods of radiation therapy have undergone tremendous changes.

Today, improved imaging and data processing techniques allow clinicians to better visualize tumors.

At the same time, the use of state-of-the-art equipment ensures effective irradiation of neoplasms. Efficiency also depends on how old the irradiation device is and what technologies are used.

It is impossible to achieve a successful outcome with outdated equipment. If state-of-the-art equipment is used, treatment outcomes will be amazing.

Dr. Stoll, can differences in equipment affect the effectiveness of the treatment?

Yes, as I said. If I am able to visualize the tumor and irradiate it without losing sight of it, then, of course, the treatment will be highly accurate and effective. Accurate imaging allows you to significantly increase the radiation dose. Therefore, the higher the dose, the higher the chances of complete tumor destruction. This approach also reduces the irradiation of adjacent healthy tissues, which helps reduce side effects.

Ultimately, radiation therapy, with the use of state-of-the-art equipment and professional knowledge, significantly increases the chance of achieving tumor control and reduces the severity of side effects. And that is exactly what we are aiming for.

Please tell us more about the characteristics of the equipment used in your clinic for radiation therapy.

There are two major global manufacturers of equipment of this kind. I will not name the manufacturers, but I will say that we are using the American model, which Siemens has bought out, and it is integrated into Siemens, specifically the German company Siemens. As far as I know, this manufacturer occupies a leading position in the market.

For example, we all know the automobile manufacturer BMW. BMW has different models: the third, fifth, and seventh series. To make it clearer, a model of the seventh series from this manufacturer is available in our clinic. Thus, we have the most advanced equipment available on the market today. This makes it possible for us to irradiate tumors the size of a pinhead. It is thanks to this state-of-the-art device that we can visualize such tumors.

Depending on the goals of therapy, large areas of the body can also be irradiated. A CT (computed tomography) scan allows us to visualize the tumor before radiation therapy. With the help of the scans, doctors can determine the exact localization of the tumor and find tiny tumor foci. If the tumor is in a hard-to-reach place, the patient can be positioned as required by the irradiation procedure, or the beams can be directed to the target area so that the irradiation proceeds according to the planned scheme. This can also be done in a variety of ways.

For example, a tumor is marked with special gold needles. Our machine has a feature called Goldmark Tracking that allows us to locate these needles for highly precise irradiation of the tumor. When the doctor has visualization data in hand and clearly sees that the tumor is in the correct position, the irradiation procedure begins, during which the rays are directed to the pathological focus from top to bottom.

A large number of tiny plates are built into the device, namely about 120. While the device rotates around the patient, beams are formed, which are eventually directed at the tumor to destroy it.

Repeated radiation therapy in the same body area has limitations. How important is it for the patient to know this before starting a course of radiotherapy in the clinic?

At this point, I would like to explain in more detail. When I started my clinical career, there was a law according to which it was forbidden to irradiate the areas of the body that had previously been exposed to a significant dose of radiation. To date, nothing has changed dramatically, but this approach is somewhat outdated.

For example, when a patient with breast cancer who was treated 10 years ago comes to us for help and the same area of the body was irradiated in the past, in many cases we can repeat radiation therapy. In such cases, special caution is required.

As for patients from abroad, it is extremely important to find out all the nuances in advance so that when the patient arrives for treatment, he knows for sure that he has no contraindications to radiation therapy. For this purpose, our clinic provides a modern means of communication. We can receive medical records and images via the Internet. As a team, we look at the patient's scans and analyze the patient's medical history and medical records together before making a decision about radiation therapy.

Thus, before the patient decides whether they want to undergo radiation therapy, we can already say what exactly we offer in terms of irradiation. We tell the patient if we are ready to provide the treatment, and the patient is able to make a final decision even before arriving at the clinic.

Dr. Stoll, tell us about the peculiarities of radiation therapy in your clinic.

As I said, our radiotherapy equipment allows us to achieve almost all therapeutic goals. The skills of the team are also very important, since a lot actually depends on the doctors too. I am lucky that I have a team of real professionals with many years of experience working with me. There are no newcomers in our team, so all specialists know their jobs perfectly. Thanks to this, we can offer our patients all the possibilities of modern radiation therapy.

Internal irradiation using the after-loading technique has already been developed. This is a new step in radiation therapy, and such a technique is not yet available in our clinic. As for irradiation with external sources that direct radiation onto the patient's body from the outside, we have at our disposal all modern devices.

How is radiation therapy in Germany different from radiation therapy in other countries? Based on your experience, what motivates patients to undergo radiation therapy in Germany?

First, of course, this is equipment. Many countries do not have such state-of-the-art equipment. Even if there are innovative technologies, doctors do not always have the necessary professional skills to work effectively with the equipment.

We therefore also offer partner programs for training in various types of radiation therapy for physicians from foreign countries. We train them, and they watch how we work with patients. Doctors can thus gain knowledge and return to their native country, where they apply it in practice.

But on the other hand, if a patient also needs modern chemotherapy or other drug treatment, they are often not available in foreign countries. Undoubtedly, in Germany, these treatments are also on a completely different level. In Germany and in Munich, in particular, medicine is at a very high level. It simply cannot be better. From my own experience, I can say that this factor also plays an important role.

I frequently travel abroad, so I can see how things are in other parts of the world. In Germany, there is a system of tumor boards. This means that when I admit patients from abroad, I analyze their cases. Following this, we, together with other specialists, for example, breast cancer experts, study the patient's clinical data. A gynecologist or oncologist then joins the tumor board, and we discuss together what kind of treatment will be optimal for the patient.

And in many other countries, this process is different because the patient seeks medical attention, and one doctor decides what treatment will be prescribed. In such situations, much important information is missed since one doctor cannot take into account all the peculiarities of a clinical case. If the doctor organizes a tumor board with other colleagues and discusses with them the patient's clinical case, together they will be able to prescribe the optimal treatment and achieve the best result.

I believe that it is the combination of state-of-the-art equipment, experience, and collaborative decision-making that is the advantage of medicine in Germany compared to other countries. I think this is the reason why patients choose treatment in Germany.

And, of course, the last reason is "Made in Germany", which implies high quality.

Some patients worry that radiation therapy may cause complications, especially when it comes to brain irradiation. It is believed that after radiation therapy, patients may lose memory or have impaired mental abilities. What could you tell patients about this?

First of all, one needs to consider the processes that occur in the brain. Basically, we can say that there are areas where irradiation causes more side effects, for example, when irradiating the ENT organs. There is also the problem of the development of swallowing disorders. There are also areas in which irradiation causes almost no side effects. For example, when irradiating the breast, the patient may experience skin burns, but there will be no other side effects. So it all depends on the specific case.

Of course, the brain is the most complex organ in the human body. And it is not at all surprising that patients are worried about complications. Whenever possible, radiation is given in minimal doses, but radiation therapy still affects the entire brain. Today, however, more and more attempts are being made to irradiate separate brain areas with special marking techniques, which we also use in our clinic. Thus, if the whole brain is irradiated, some parts of the organ can be saved from radiation. The use of high-tech equipment makes it possible to protect some areas of the brain, which are especially important for preserving the thinking and mental abilities of a person.

Globally, doctors must always understand what they are dealing with. If I decide to irradiate large areas of the brain, then this is necessary because tumor growth usually progresses there, as a result of which complications are inevitable, but due to the oncological process and not because of radiation. Our task is to prevent such a scenario.

So the specialist must always look at the specific clinical case and irradiate the tumor with the optimal dose of radiation. The type of radiation therapy depends on the specific disease.

Dr. Stoll, what advice would you give to patients who have not yet decided where they want to receive radiation therapy?

Patients are worried about how their treatment will go. And their fears are justified because their lives are at stake. And with diseases such as cancer, patients do not know at all what awaits them ahead. They have never dealt with radiation and do not know what to do.

The patient can find information about the clinic. It is important to know what equipment is used here. Patients should also get information about the attending physician. The data can then be compared. If the clinic uses outdated equipment, it is better to contact a medical facility that has advanced equipment.

Another important point is that patients need to feel that they trust their doctor. If the attending physician provides poor quality treatment or is unsure whether he can help the patient, the patient is likely to be distrustful. In such cases, it is better to refuse the services of such a doctor.

Of course, all these issues can be revealed only in the course of communication. So my advice would be this: the patient must be sure that the clinic has state-of-the-art equipment and the necessary experience. You also need to pay attention to how long the physician has been performing radiation therapy and to some other aspects. It is very important that patients trust their doctor. That is my advice to patients.

It goes without saying that a successful treatment outcome depends on the experience of the team of doctors and, of course, God's will.

Dear Dr. Stoll, thank you very much for the informative interview! It is nice to know that there are doctors like you. I wish you all the best!

Contact Booking Health

Read:

Treatment of prostate cancer with radiation therapy

Hydrogel spacers treatment for prostate cancer in Germany

Proton therapy – advanced cancer treatment method

Gamma Knife, treatment of a brain tumor in Germany

Treatment of tumors with Cyber Knife in Germany

---